GU EXAM / DRE

Question 1

DRE allows palpation of only the ________ surface of the prostate gland

Answer 1

posterior

Question 2

The DRE by itself if NOT an adequate screening for

Answer 2

COLORECTAL CANCER

Question 3

patient’s attitude can be affected by

Answer 3

• religious & cultural beliefs

- previous positive or negative experiences

Question 4

common positions for the DRE

Answer 4

Modified lithotomy = patient on back, knees flexed
Sims position = for bedridden patients (left lateral)
Standing, hips flexed with upper body on table

Question 5

Any swelling in the scrotum other than the testicles should be evaluated by

Answer 5

TRANSILLUMINATION

Question 6

diameter of normal prostate

Answer 6

2.5 cm

Question 7

patients should feel the urge to __________ when you palpate the prostate

Answer 7

urinate

Question 8

prostate should feel __________

Answer 8

smooth & rubbery

not tender

Question 9

normal prostate vs BPH vs prostate cancer vs prostatitis

Answer 9

NORMAL PROSTATE

• about 2.5 cm from side to side
• prominent median sulcus
• consistency = rubbery and smooth
• tenderness is not usual, and patients should feel the urge to urinate when you palpate

BPH

• enlargement of gland is symmetrical
• marked protrusion into rectal lumen
• smooth with no nodularity
• median sulcus may be indistinguishable
• consistency is rubbery or slightly elastic

PROSTATE CANCER

• asymmetric shape
• hard consistency
• discrete nodule may be palpable
• median sulcus often obscured

ACUTE PROSTATITIS

• prostate gland is swollen and “boggy”
• firm consistency
• very tender to touch
• examine the gland carefully and pay attention to patient’s verbal & nonverbal cues

Question 10

acute prostatitis

Answer 10

• prostate gland is swollen and “boggy”
• firm consistency
• very tender to touch
• examine the gland carefully and pay attention to patient’s verbal & nonverbal cues

Question 11

prostate cancer

Answer 11

• asymmetric shape
• hard consistency
• discrete nodule may be palpable
• median sulcus often obscured

Question 12

BPH

Answer 12

• enlargement of gland is symmetrical
• marked protrusion into rectal lumen
• smooth with no nodularity
• median sulcus may be indistinguishable
• consistency is rubbery or slightly elastic

Question 13

2 principle screening tests for prostate cancer

Answer 13

DRE & PSA

…….however

⦁ The DRE only reaches the posterior and lateral surfaces of the prostate
⦁ PSA can be elevated for benign conditions